Envisioning Health Mobility In India

Pradeep Nair
Dean, School of Journalism,
Mass Communication and New Media,
Central University of Himachal Pradesh,
Dharamshala

The health care sector is the primary service provider and welfare setup which also contributes largely to the Indian economy in terms of revenue and employment generation as it is the third-largest contributor to the Indian economy in terms of potential to generate revenue and employment. The growing outreach of digital technology and mobile phones would change the face and scope of the health service and its delivery. It would not only fasten up the access and excellence in medical facilities but would also change the perception of and about health. This would boost the community health practices, preventive healthcare and breaking up of epidemic diseases. This article simultaneously underlines the need to check the overt commercialization of health services which may confine health for wealth instead of inclusive health and medical practices and services.

The Indian healthcare sector encompasses hospitals, pharmaceuticals, medical equipment and supplies, medical insurance, and diagnostics. Among the primary subsectors of the healthcare sector, hospitals, and pharmaceuticals account for the largest revenue, contributing as much as 71 per cent and 13 per cent of the total revenue annually. The sector is expected to grow to US $ 158.2 billion in 2017 from the US $ 81.2 in 2014-15. The per capita healthcare expenditure has increased at a compound annual growth rate (CAGR) of 10.3 per cent from the US $ 43.1 billion in 2008 to the US $ 57.9 in 2011 and is expected to rise to US $ 88.7 by the end of 2015. Further, the growth of mobile and wireless communication-based healthcare is also expected to reach the US $ 0.6 billion for India in 2017. The smartphone industry in India has been witnessing explosive growth in the last two three years. In the first quarter of 2014, the smartphone shipments in India reached 17.59 million with a staggering growth of 186 per cent. Thus, the mobility-based health industry is brimming with new health applications, devices and services.

The Indian healthcare industry has grown considerably in recent years, contributing around $ 30 billion, which amounts to five per cent of the GDP and is all set to cross $ 280 billion by 2020. In terms of percentage of GDP, India spends less on healthcare services than many of the developing economies of the world. Even though the government earmarked approximately $ 55 billion for healthcare under the 12th Five Year Plan, the investment is not adequate to meet the target of universal healthcare. At current growth rates, the health infrastructure will be unable to keep pace with the increasing demand for better healthcare for all and in coming years India will end up with a total bed density of around 1.7 to 1.9 per 1,000 people against the global average of 2.9, and the WHO guidelines of 3.5. The health service providers’ density will also remain only 1.7 per 1000 by 2022.

The reason for considering mobile as the most efficacious media tool to interconnect healthcare providers, practitioners and other stakeholders to a substantially large number of consumers in the healthcare system is that the mobile phone subscribers in India have reached 933 million in the first quarter of 2014 (TRAI, 2014). The prices of smartphones have also come down significantly, from $ 200 to $ 50 (Morgan Stanley Report on India’s Telecommunication Sector, 2013). It is the right time to understand that the future of healthcare services in India lies in mobility. Today, mobility is one of the most promising innovations and is expected to transform the way healthcare services reach the patient. India has witnessed significant activity in the mobile health space with the launch of several different services; however, the majority of initiatives are focused on spreading prevention and awareness messages. Entrepreneurship in mobility for health has now entered the Indian market as a lot of ICT-enabled health solution providers like Rockefeller Foundation, United Nations Foundation, Vodafone Foundation, GSM Association, PEPFAR (President’s Emergency Plan for AIDS Relief) and Health 3.0 have marked their presence in India.

Mobile technologies include mobile phones, personal digital assistants (PDA) and smartphones like blackberry, palm pilot, iPhone, enterprise digital assistants (EDA), and handheld and ultra-portable computers such as tablet PC, iPad and smartbooks. These devices have a range of functions and applications like photos and video (MMS), telephone and World Wide Web access and software application support. Technological advances and improved computer processing power mean that single mobile devices such as smartphones and iPads are increasingly capable of high-level performance in many of these functions. The features of mobile technologies that may make them particularly appropriate for improving healthcare service delivery processes relate to their popularity, their mobility, and their technological capabilities. The popularity of mobile technologies has led to high and increasing ownership of mobile technologies, which means interventions can be delivered to large numbers of people. The mobility of mobile technologies means that many people carry their mobile phones with them wherever they go. This allows the temporal synchronization of the intervention delivery and allows intervention to claim people’s attention when it is most relevant. For example, healthcare consumers can be sent appointment reminders that arrive the day before or morning of their appointment. Real-time (synchronous) communication also allows interventions to be accessed or delivered within the relevant context, i.e. the intervention can be delivered and accessed at any time and wherever it is needed. For example, at the time healthcare service providers see a patient; they can access the management support system providing information and protocols for management decisions to whoever requires them. This is relevant for providing clinical management support in settings where there is no senior or specialist health care provider support or where there is no such support at night or weekends. As mobile technologies can be transported wherever one goes, interventions are convenient and easy to access.

From a technology perspective, the transformation of Indian healthcare can be seen via online databases, applications, e-hospital application, mobile apps, platforms and SMSs. All these applications have changed the way healthcare service is perceived, received and consumed in India. Online databases give patients the ability to check out what drugs are available in which pharmacies, thereby saving them the effort to hunt for their medications. Applications enable the service providers to track the patient’s medical records and allow them to take multiple opinions from other care providers. With the help of mobile apps, one can very easily track calorie intake, help manage diets and monitor fitness schedules and provide useful reports on demand. Platforms like MOTECH (Mobile Technology for Community Health) have transformed disease management in rural India by managing sample tracking, treatment registration and adherence, patient tracking, treatment reminders and alerts and reporting. SMS services are widely used to disseminate information on NGO/government-led health care campaigns. New services like Mediphone offer a tele-triage facility for immediate care related to acute minor ailments over the phone. The service allows everyone to get medical advice from an expert team of doctors and qualified para-medical staffs. This service can be used for all the daily medical needs and can provide health advice anywhere a mobile connection is available at an affordable cost. All these services and applications are leveraging healthcare mechanisms to drive efficiency and effectiveness across the country. A lot of efforts are taken by the health industry and policymakers to sustain these applications and services. Policymakers are developing policies and agendas for health. Both government and non-government organizations are committed to encouraging the use of mobile-enabled services by public healthcare providers, and a lot of healthcare organizations and agencies are providing incentives to private providers to invest in mobile and other wireless health information technologies. The issues of certification, standardization and interoperability are also addressed in various public domains.

The rapid advancements in mobile communication technology are providing enormous benefits to all the stakeholders in a healthcare system by helping them to track the genuineness of medicines, enhancing patient-care provider communications promptly for updates required for diagnosis and treatment and monitoring the improvements in the treatment through real-time data. The information which was distant at one time and is placed at different places – hospitals, clinics, laboratories, pathologies -is now possible to store at one place accessible by the patients and the service providers 24×7 from anywhere at any platform – web, mobile, desktop, iPad, tablet. All this is happening not only because of the technology, especially the wireless mobile technology, but also because of the shift taking place in the mindset and behaviour of the patients, healthcare providers, pharmacists, para-medical staff, and the technology vendors. Thus, the impact on the quality of healthcare is now clearly visible to some extent. The only requirement is to collaborate across the healthcare industry to integrate technology systems, applications and workflows to unleash the power of health mobility to facilitate the safe and secure exchange of accurate and timely information to increase the efficiency of healthcare service providers and to drive value and improve quality in the healthcare system. For making all this possible to a larger number, it is the right time to utilize and connect the country’s all available information highways, networks and stakeholders – patients, doctors, technology vendors, health systems, pharmacies, health plans, and policies—into an integrated healthcare system facilitated by mobile communications to exchange critical health information through a single point of connectivity to deliver better healthcare to all the stakeholders irrespective of socio-economic status, geographies, and technicalities.